by Somei

Hello Everyone,

We are currently trialing the BD Insyte-N catheter in our Level III unit. We use the Jel-co Accu-vance, but were experiencing problems with IV starts and longevity of our IV's.

During the trial of the BD's we are finding that we get great blood return, but then upon flushing the vein "blows". The BD's are definitely sharper, I'm sure it's a case of us going through the back of the vein. However, our most experienced nurses who rarely need more than one "stick" to be successful are now sticking multiple times to get it.

What type of catheters do you use in your unit and if you use BD, have you experienced the same difficulties we are experiencing through our trial of the BD Insyte-N?

Thanks Much!

Re: What Type Of IV Catheters Do You Use?

We also changed from the Accuvance to the Insyte caths and experienced the same frustrations that you describe. Over time we got used to them and our success rate went back up. I think the key is to go verrrrrrry slow, and not to advance any further once you see your flashback. Hold the stylet still at that point and slide the cath off. I think you are right- you probably are going through the vessel. I know how you feel. You feel like youre torturing the baby and want your old product back. Its a shame that several products cant be in stock, so you can just use the one you have success with. Hang in there and good luck!

Re: What Type Of IV Catheters Do You Use?

We use the BD Insytes. We have used them for so many years now...I have no idea what we used before but I remember when we switched there were some people who didn't like it but now we all do. Patience I guess.

Re: What Type Of IV Catheters Do You Use?

We use the InSytes too.Haven't noticed a problem.Maybe the needle is a tad longer than you're used to and you advance it a wee bit too far?

Re: What Type Of IV Catheters Do You Use?

I think I was trialing the Insytes once on a 500 gm baby--got in the vein, went to pull the stylet out and the whole thing came out. Man, was I steamed.

Of all of the safety-types, I prefer the Accu-vance, and they're available, but we're still able to get good old Jelcos, and that's what I use. And no needle sticks yet.

Re: What Type Of IV Catheters Do You Use?

We use the Insytes. We liked them better before they had the safety mechanism, though!!! Nurses hoarded those when we switched over, and had secret stashes of the old ones in their lockers for really hard IV sticks. It took awhile, but now we've gotten used to the new ones and are doing fine with them. It just takes practice to get to know their quirks.

Definitely need to twist the actual catheter a bit before insertion, otherwise it sticks and you can't get it off the needle. So twist it around a bit first, then twist it back until it settles into the bottom groove. Don't hit the white needle withdrawl button while the needle is still in the baby - remove the needle then hit the button after it's out. I think the company told us to retract the needle while still in the patient, for safety reasons - but it seemed to screw up perfectly good IV sticks so we stopped doing that.

Re: What Type Of IV Catheters Do You Use?

Now that I think about it, the only problem I have with the In Sytes is that the needle sticks when I push the retract button. So yes, do make sure you have withdrawn the needle first or it'll sick in the catheter.

Re: What Type Of IV Catheters Do You Use?

I have been a nurse forever and ever and I never stuck myself using the old (non-safety) needles. They are much, much better for the patients....why should we force the patients to endure being tortured while we "get good at" putting these "safety" iv's in? I just started at a new hospital and they use the JOhnson and Johnson IV caths....they are telling us to go in at a 45 degree angle (when was the last time I did THAT?) and just about every patient I have worked with in my brief time at this new facility has gotten phlebitis. I'm trying to gather data on this. I think the isertions are so traumatic that they set patients up for problems.

Re: What Type Of IV Catheters Do You Use?

23g Instyles! I love them!

I'm sure you guys will just have to get used to them. Best of luck!

Re: What Type Of IV Catheters Do You Use?

Oh & we have 2 length of needles.